Claim CLM-2024-001048

Claim CLM-2024-001048
59/60

Key Facts

LOB:MOTOR
Loss Type:Collision - Own Fault
Outcome:Repaired
Amount:GBP 6,735
Risk Score:0 (low)
Date of Loss:2024-11-22
Settlement:GBP 6,735

Timeline

2024-11-22Incident occurred
2024-11-23Claim reported
2024-11-25Assessment completed
2024-12-07Decision made
2024-12-09Claim closed

Analysis

NEEDS REVIEW
4 FAIL4 WARN17 PASS
FAILS1Duplicate or Near-Duplicate Payments
FAILS2First Contact Delay
FAILS2Promised Follow-Up Not Completed

Inspections

25 inspections
Summary
CommsFirst Contact DelayFAILS294%SLA breached2
CommsPromised Follow-Up Not CompletedFAILS287%Promised callback not made3
FinanceDuplicate or Near-Duplicate PaymentsFAILS178%Duplicate detected2
EvidenceDocument Quality Too LowFAILS375%Engineer report too blurry to read3
FileDocument Extractability / OCR RiskWARNS377%Needs attention1
FileClaim Story ConfidenceWARNS388%Needs attention1
FinanceReserve Category MismatchWARNS383%Reserve category unusual but valid1
FinanceClosed with Open Financial ItemsWARNS294%Small reserve open at closure1
FileRequired Evidence PresencePASSS288%All required documents present2
FileTimeline CoherencePASSS273%No sequence anomalies2
FileStructured vs Narrative MismatchPASSS275%Structured fields match narrative1
LiabilityLiability Stance ContradictionPASSS271%Liability stance is consistent1
LiabilityDispute Without Evidence PackPASSS295%Evidence pack present2
LiabilitySplit Liability Settlement InconsistencyPASSS277%Settlement matches2
CommsNo-Update GapPASSS272%No communication gaps1
CommsFinal Decision Explanation MissingPASSS290%Decision explanation sent2
RepairRepair Cycle Time OutlierPASSS285%Repair cycle within expected range1
RepairRework Loop DetectedPASSS274%No rework detected1
RepairInvoice vs Authorization MismatchPASSS286%Invoice matches authorization2
RepairSupplier Delay Attribution MissingPASSS378%Delays documented and attributed2
TL/ValMissing Valuation Evidence PackPASSS180%Engineer report present1
TL/ValDeductions Without JustificationPASSS289%Deductions properly justified2
FinancePayment Without Supporting ArtifactPASSS293%Artifacts linked1
EvidenceCritical Document MissingPASSS282%All expected documents present1
EvidenceTranscript Not AvailablePASSS376%Communication documented1
Evidence

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